Sunday, February 07, 2016

Slate Star Codex on Superforecasting

When hospitals created cardiac care units to treat patients recovering from heart attacks, Cochrane proposed a randomized trial to determine whether the new units delivered better results than the old treatment, which was to send the patient home for monitoring and bed rest. Physicians balked. It was obvious the cardiac care units were superior, they said, and denying patients the best care would be unethical. But Cochrane was not a man to back down…he got his trial: some patients, randomly selected, were sent to the cardiac care units while others were sent home for monitoring and bed rest. Partway through the trial, Cochrane met with a group of the cardiologists who had tried to stop his experiment. He told them that he had preliminary results. The difference in outcomes between the two treatments was not statistically signficant, he emphasized, but it appeared that patients might do slightly better in the cardiac care units. “They were vociferous in their abuse: ‘Archie,’ they said, ‘we always thought you were unethical. You must stop the trial at once.'” But then Cochrane revealed he had played a little trick. He had reversed the results: home care had done slightly better than the cardiac units. “There was dead silence and I felt rather sick because they were, after all, my medical colleagues.”